阿仑膦酸钠联合鲑鱼降钙素对老年髋部骨质疏松骨折患者骨密度及血清BGP、PTH、BALP水平的影响

Curative Efficacy of Alendronate Combined with Salcatonin in Treatment of Osteoporotic Hip Fracture for Elderly Patients and Its Effects on Bone Mineral Density and Serum Levels of BGP,PTH and BALP

目的:研究阿仑膦酸钠联合鲑鱼降钙素对老年髋部骨质疏松骨折患者骨密度及血清骨钙素(BGP)、甲状旁腺激素(PTH)、骨碱性磷酸酶(BALP)水平的影响。方法:收集2014年6月至2015年6月我院接诊的90例老年髋部骨质疏松骨折患者,按抽签法随机分为实验组和对照组,每组各45例。两组均给予手术治疗,术后进行康复锻炼并常规补充钙剂,每次500 mg,每天2次。对照组在此基础上采用阿仑膦酸钠治疗,每次70 mg,每周1次。实验组在对照组基础上采用鲑鱼降钙素治疗,每次100IU,每天1次。两组均治疗24周。观察和比较两组患者的临床疗效、治疗前后骨密度、血清BGP、PTH、BALP、VAS水平及生活质量评分的变化。结果:实验组总有效率显著高于对照组(P<0.05);实验组腰椎、股骨颈、Wards三角区骨密度显著高于对照组(P<0.05);实验组BGP、BALP显著高于对照组(P<0.05),实验组PTH显著低于对照组(P<0.05);实验组VAS评分显著低于对照组(P<0.05)。结论:阿仑膦酸钠联合鲑鱼降钙素治疗老年髋部骨质疏松骨折疗效显著,能够增强骨密度,促进骨折愈合,可能与其有效调节血清骨代谢BGP、PTH、BALP的水平有关。

Objective： To study the curative efficacy of alendronate combined with salcatonin in the treatment of elderly patients with osteoporotic hip fracture and its effects on the bone mineral density, bone glaprotein（BGP）, parathyroid hormone（PTH）, bone alkaline phosphatase（BALP） levels. Methods： 90 cases of elderly patients with osteoporotic hip fracture who were treated from June 2014 to June 2015 in our hospital were selected as the research objects. According to the draw method randomly divided into the experimental group and the control group, with 45 cases in each group. Both groups were given surgical treatment, postoperative rehabilitation exercise, routine calcium supplement, each 500 mg, twice daily. The control group was additionally treated with alendronate, each 70 mg, 1 times a week, while the observation group was treated by salcatonin on the basis of control group, every time 100 IU, 1 times a day. Both groups were treated for 24 weeks. Then the therapeutic effect, bone mineral density before and after treatment, serum BGP, PTH, BALP level, VAS and changes in quality of life score were compared between two groups. Results： The total effective rate of experimental group was significantly higher than that of the control group（P〈0.05）; the BMD of lumbar spine, femoral neck and Wards triangle were significantly higher than those of the control group（P〈0.05）; the BGP and BALP were significantly higher than those of the control group（P〈0.05）, PTH was significantly lower than that of the control group（P〈0.05）. The VAS score was significantly lower than that of the control group（P〈0.05）, the quality of life score was significantly higher than that of the control group（P〈0.05）. Conclusion： Alendronate combined with salcatonin was effective for the osteoporotic hip fracture, which could increase the bone density, It may be related to the regulation of BGP, PTH and BALP expression in serum.